Skin cancer continues to rise in the UK and globally, the overall statistics being a cause for great concern. Research has shown that of those aged 55 or over, some 70% will develop skin cancer. It is, sadly, a problem that will come to many of us.
For most, though, there is uncertainty as to what skin cancer actually looks like. Which blemish is of no concern, which one might signify cancer and then which type of skin cancer might it be?
If the skin has changed, is that cause for concern, which parts of the body should someone particularly focus on if looking for any evidence of problems?
In this post, Anca Breahna, a plastic and cosmetic surgeon with specialist knowledge in the field of skin cancer and its treatment, will provide some key information. At Anca’s NHS practice, skin cancer is one of the areas on which she focusses and she has also trained other surgeons in procedures relating to skin cancer and is heavily read in this topic. She is a surgeon with a wealth of relevant knowledge and experience in the skin cancer field.
The statistics outlining just how common skin cancer is in the UK are alarming, but they do require a degree of extra context. There are three types of skin cancer and by far the most common – accounting for around 80% of cases – is Basal Cell Carcinoma, also known as Rodent Ulcer, this the least serious of the three.
In this case, least serious does not mean it can be ignored, there is still a requirement to have the cancer checked and surgery may be necessary, however it is rare for this form of skin cancer to spread to other parts of the body. There can, though, still be significant damage to cells local to the cancer.
Squamous Cell is the second most common form of skin cancer, which poses a far greater risk to health than BCC but can be effectively treated, especially if detected early.
The third form is melanoma, by far the most serious form of skin cancer and one that can spread to other parts of the body. For there to be effective treatment of melanoma, early detection and then the appropriate treatment are both essential.
At this juncture it is important to state that it is not possible to give definitive advice online that will allow someone to confidently identify first whether they have skin cancer and, secondly, which form it might be.
We can give general advice but anyone with any concerns about changes to their skin, the growth of a new mole or similar or alterations to existing moles should seek medical advice. That could be through a GP, equally please feel free to contact Anca.
In general terms, you would be looking for change to the skin, that might be a new mole, nodule or ulcer or changes to an existing blemish.
For Basal cell Carcinomas, the usual presentation would be a new small nodule or ulcer, this likely to be in an area that has received heavy sun exposure. This form of skin cancer is more common in those with fair skin, though that of course is not to say that anyone with darker skin can confidently be sure they are immune.
The fact that the visible sign might be just a very small nodule shows that this can be a difficult form of cancer to detect and so regular self checking is advised so it is possible to easily get a sense for what is new and changed.
Squamous Cell Carcinomas are again most common on those areas exposed to the sun. Priority should be given to checking the face and other areas that are left in the sun – arms and legs for instance, but don’t forget the backs of hands, these often overlooked despite being perhaps the area that receives most exposure of all.
This form of cancer can be shown by blemishes that are warty and crusted and so they can be easier to spot than the BCC form. Unlike the Basal cell skin cancer, which invades locally, the SCC can spread elsewhere and so there is a far greater need for quick treatment.
The third common form is the Melanoma. The huge majority, more than 95% are shades of brown through to black, though they can be pink or skin coloured. Melanomas are usually detected through the appearance of a new mole or the changing of an existing one, they also tend to have an irregular shape and consist of more than one colour.
The mole may become larger than usual and may itch or bleed.
There are areas where it is more common to see a melanoma, and yet focussing on these can breed false confidence as there are still many thousands of cases where the Melanoma will be found in less common parts of the body. Wherever it may be on the body, a new mole, one that changes in size, one that has an irregular shape, mix of colours, or itches and bleeds would be a cause for concern.
Diagnosing melanoma can be difficult even for a doctor, however an ABCDE system can be used as a starting point, the labels being:
A – Asymmetry – are the halves uneven?
B – Border – is it irregular, crusted or notched?
C- Colour – has there been a change in colour or is the colour varied
D – Diameter – Typically 6mm or more, though they can be smaller
E – Evolving – is the mole changing over time
In addition, anyone who has a growth on the skin that regularly forms a crust or bleeds and does not heal should have the area checked.
On paper, there might seem a reasonable distinction between the three forms of skin cancer, but in reality it can be far more difficult for anyone looking at their own body. Has the mole grown or has it always been that size? Is this a new nodule or mole or am I seeing it just because I’m really checking now?
Your job is not to self diagnose, your job is simply to check regularly and to be alert to changes. If you do carry out regular checks you will get a sense for what’s new and changed and from this a sense of whether you need to take action.
You can see your GP or book a consultation with a cosmetic surgeon with the relevant experience – one of advantage of this route would be an ability to quickly book in any surgery that may be required, especially for the more serious forms of skin cancer.
It is of course entirely possible to consult via video and images, this especially important given current ongoing restrictions linked to the Covid-19 pandemic. Your overall health does not need to suffer simply because it may be hard to get a consultation in person.
If you would like further information or to discuss your options for consultation please contact Miss Breahna by calling us at 07538 012918 or email at contact@ancabreahna.com